VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
46,870MODERNA
532GLAXOSMITHKLINE BIOLOGICALS
353PFIZER\BIONTECH
231MERCK & CO. INC.
221UNKNOWN MANUFACTURER
62SEQIRUS, INC.
25DYNAVAX TECHNOLOGIES CORPORATION
13EMERGENT BIOSOLUTIONS
12SANOFI PASTEUR
9NOVARTIS VACCINES AND DIAGNOSTICS
5PFIZER\WYETH
5PAXVAX
2TEVA PHARMACEUTICALS
2PROTEIN SCIENCES CORPORATION
1BERNA BIOTECH, LTD.
1INTERCELL AG
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL1,906
1,575
289
IMM209286
252
236
229
s029456178
171
UT7065MA166
155
149
145
S034636133
107
U62828AA103
100
98
P10025327596
U6737AA85
UJ446AA79
78
78
59
57
4BH3254
4F47253
52
27656352
50
PP9L548
49TM346
42
40
38
MENVEO38
4F47237
R1B252M36
34
C5763AA30
93362229
25
300057A24
UNK24
22
CW311621
18
17
15
UH894AB15
3Y7NL12
R1B743M12
EJ168611
el128410
10
10
10
9
ARBA141A9
UNK9
8
UNK8
8
1F4EB8
Unknown7
7
No batch number6
5
5
UJ090AA5
5
5
4
4
4
UNK4
JEV18K95E4
UNK3
A115A3
Z127A3
3
3333324181073
2
2
2
TAR352
1
1
1
1
1
A739081
1
1
1
1
1
037K20A68,542
EL128447,700
133

Incidents per State

State Total
15,185
CA14,096
NY7,507
TX7,196
FL6,939
IN5,527
PA4,560
IL4,179
OH4,054
AZ3,856
MI3,771
NJ3,411
MA3,278
VA3,208
NC3,114
WA3,034
GA2,864
MD2,652
MN2,534
CO2,532
WI2,457
MO2,029
OR1,943
TN1,715
CT1,693
KY1,603
OK1,226
AL1,201
KS1,162
IA1,157
SC1,106
NM1,065
UT973
AR951
LA945
NE829
NV797
ME795
MT789
NH756
ID674
AK661
WV661
PR650
MS585
HI536
RI510
VT441
SD361
ND356
DE350
DC239
WY209
GU32
AS16
VI13
MP9
MH3
FM2
QM1
XB1

ID: 0984887
Sex: F
Age: 30
State: TX

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Injected 0.5 ml subcutaneous into her right arm; Right arm very painful; A spontaneous report was received from a pharmacist concerning a 40-year-old, female patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and was injected 0.5 ml subcutaneous (SQ) into right arm and right arm very painful. The patient's medical history was not provided. Concomitant medications reported included birth control (not specified). On 21 Jan 2021, 'the patient received their first of two planned doses of mRNA-1273 (Lot number: 027L20A) subcutaneously in the right arm for COVID-19 infection. On 21 Jan 2021, the nurse vaccinator injected 0.5 ml subcutaneously (SQ) into the underside, fatty part, of the patient's right arm, in error. That night, the patient's right arm "hurt like hell" and was very painful. No treatment medications were reported at the time of this report. Action taken with mRNA-1273 in response to the events was not reported. The event, injected 0.5 ml subcutaneous (SQ) into right arm, was resolved on 21 Jan 2021. The outcome of the event, right arm very painful, was not reported.; Reporter's Comments: This report refers to a case of product administration error for mRNA-1273 (Lot number: 027L20A) , where the first dose of the vaccine was administered subcutaneously. The event of Pain in arm was associated with this case of incorrect route of product administration.

Other Meds:

Current Illness:

ID: 0984888
Sex: F
Age: 17
State: MN

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Received Moderna vaccine as minor, age 17; A spontaneous report was received from a consumer concerning a 17-years-old, female patient who received Moderna's COVID-19 Vaccine, and the patient received Moderna vaccine at the age 17. The patient's medical history included a positive Covid-19 test in Aug 2020, symptoms resolved, and she completed her quarentine. Concomitant product use was not provided by the reporter. On 28 Dec 2020, the patient received their first of two planned doses of mRNA-1273 (Lot number 026L20A) intramuscularly for prophylaxis of COVID-19 infection. On 28 Dec 2020, patient received Moderna vaccine as minor, age 17. Treatment information was not provided. Action taken with mRNA-1273 in response to the event was not provided. The outcome of the event received Moderna vaccine as minor, age 17 was resolved on 28 Dec 2020.; Reporter's Comments: This case concerns a 17-year-old female patient who received their first of two planned doses of mRNA-1273 (Lot number 026L20A), reporting Product administered to patient of inappropriate age without any associated adverse events.

Other Meds:

Current Illness:

ID: 0984889
Sex: M
Age:
State: FL

Vax Date:
Onset Date:
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Potentially injected vaccine into the subcutaneous fat beneath the deltoid; A spontaneous report was received from a pharmacist concerning a male patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and experienced potentially injected vaccine into the subcutaneous fat beneath the deltoid. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received the first dose of mRNA-1273 for prophylaxis of COVID-19 infection, after that the patient experienced fever and chills, which was resolved within 24 hours. On an unknown date, the patient received their second dose of mRNA-1273 subcutaneously for prophylaxis of COVID-19 infection. On an unknown date, the patient's second dose was administered by a nurse who squeezed the recipient's arm and potentially injected vaccine into the subcutaneous fat beneath the deltoid. The patient did not experience symptoms after their second dose. No treatment information was provided. There was no change planned to the dosing schedule of mRNA-1273 in response to the events fever and chills. The patient received both scheduled doses of mRNA-1273 prior to the event potentially injected vaccine into the subcutaneous fat beneath the deltoid, therefore action taken with the drug in response to the event is not applicable. The events, potentially injected vaccine into the subcutaneous fat beneath the deltoid was considered resolved. The outcome of the events fever and chills were unknown.; Reporter's Comments: This report refers to a case of product administration error for mRNA-1273, where the vaccine was administered into the subcutaneous fat. There were no reported AEs associated with this case of incorrect route of product administration.

Other Meds:

Current Illness:

ID: 0984890
Sex: M
Age: 16
State: VT

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Dose was given to 17 years old; A spontaneous report was received from a pharmacist concerning a 17-years-old, male patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and patient received the vaccine at the age of 17 years old. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On 21 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Lot number 013L20A) intramuscularly (IM) in the right arm for prophylaxis of COVID-19 infection. Pharmacist confirmed the age of the patient is 17 years old, not 15 as stated in the voicemail. She reports that the patient received the Moderna COVID19 vaccine on 21 Jan 2021 on right arm as IM injection. Patient reported no symptoms. Treatment information was not provided. Action taken with mRNA-1273 in response to the event was not provided. The outcome of the event dose was given to 17 years old was resolved on 21 Jan 2021.; Reporter's Comments: This case concerns a 17-year-old male patient who received their first of two planned doses of mRNA-1273 (Lot number 013L20A), reporting Product administered to patient of inappropriate age without any associated adverse events.

Other Meds:

Current Illness:

ID: 0984891
Sex: F
Age: 50
State: MI

Vax Date: 12/27/2020
Onset Date: 01/07/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: Bilateral ultra sound of axilla and mammogram on 1/7/21 performed by PCP.

Allergies:

Symptoms: Swollen lymph nodes in bilateral axilla.

Other Meds:

Current Illness:

ID: 0984892
Sex: F
Age: 17
State: NV

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Administered the Moderna COVID-19 vaccine to a 17 year old; A spontaneous report was received from a pharmacist concerning a 17-years-old, female patient who received Moderna's COVID-19 Vaccine, and who was administered the Moderna COVID-19 vaccine to a 17-year-old. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On 19 Jan 2021, the patient received their first of two planned doses of mRNA-1273 intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 19 Jan 2021, Pharmacist administered the Moderna COVID-19 vaccine to a 17-year-old. Treatment information was not provided. Action taken with mRNA-1273 in response to the event was not provided. The outcome of the event administered the Moderna COVID-19 vaccine to a 17-year-old was considered resolved on 19 Jan 2021.; Reporter's Comments: This case concerns a 17-year-old female patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product administered to patient of inappropriate age.

Other Meds:

Current Illness:

ID: 0984893
Sex: F
Age: 57
State: NV

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: received the Moderna COVID-19 vaccine for their first dose on 30Dec2020 and then the Pfizer COVID-19 vaccine for their second dose on 21Jan2021/ vaccine mix-up; A spontaneous report was received from a consumer concerning a 57-years-old, female patient who received Moderna's COVID-19 Vaccine, and received the Moderna COVID-19 vaccine for their first dose on 30Dec2020 and then the Pfizer COVID-19 vaccine for their second dose on 21Jan2021/ vaccine mix-up (wrong product administered). The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On 30-Dec-2020, prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 (Lot number 025J20-2A) intramuscularly in the right arm for prophylaxis of COVID-19 infection. On 30-Dec-2020, patient received the Moderna COVID-19 vaccine for their first dose and then the Pfizer COVID-19 vaccine for their second dose on 21-Jan-2021. Treatment information was not provided. Action taken with mRNA-1273 in response to the events was not provided. The outcome of the event received the Moderna COVID-19 vaccine for their first dose on 30Dec2020 and then the Pfizer COVID-19 vaccine for their second dose on 21Jan2021/ vaccine mix-up (wrong product administered) was not provided.; Reporter's Comments: This report refers to a case of wrong product administered for mRNA-1273. There were no reported AEs associated with this case.

Other Meds:

Current Illness:

ID: 0984894
Sex: F
Age: 49
State: WA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Received Pfizer vaccine for first dose and Moderna vaccine for second; Arm pain; Fatigue; Headache; A spontaneous report was received from a nurse concerning a 49-year old, female patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and experienced received Pfizer vaccine for first dose and Moderna vaccine for second, arm pain, fatigue, and headache. The patient's medical history included intervertebral disc disorder. No relevant concomitant medications were reported. On 08 Jan 2021, prior to the onset of the events arm pain and fatigue, the patient received a dose of mRNA-1273 (Lot number 25L20A) intramuscularly for prophylaxis of COVID-19 infection. On 21 Dec 2020, the patient received their first dose of the Pfizer vaccine. On 08 Jan 2021, the patient was inadvertently administered a dose of the Moderna vaccine, and experienced some arm pain, fatigue, and headache. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The event, received Pfizer vaccine for first dose and Moderna vaccine for second was considered resolved on 08 Jan 2021. The events, arm pain and fatigue, were considered resolved on 09 Jan 2021. The outcome of the event, headache, is unknown.; Reporter's Comments: This case concerns a 49-year old female patient with a medical history of intervertebral disc disease. The patient experienced Wrong product administered and non-serious listed events of Pain in extremity, Fatigue and Headache after receiving a dose of mRNA-1273 (Lot number 25L20A). Based on temporal association between the use of the product and the onset of the events, a causal relationship cannot be excluded and the events are considered possibly related to the vaccine. Of note, patient's underlying intervertebral disc disease may have been contributory for the event of headache.

Other Meds:

Current Illness:

ID: 0984895
Sex: M
Age: 59
State: VA

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: N/A

Allergies: NO

Symptoms: Pain in injection srea

Other Meds: Metformin

Current Illness: None

ID: 0984896
Sex: M
Age:
State: AR

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Some of the vaccine spilled down the patients arm; Some of the vaccine spilled down the patients arm; A spontaneous report was received from a pharmacist concerning a male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and some of the vaccine spilled down the patient's arm. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On 14 Jan 2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On 14 Jan 2021, during administration of the mRNA-1273 vaccine some of the vaccine spilled down the patient's arm. The patient believed things were not screwed on properly. No treatment information was provided. Action taken with the second dose of mRNA-1273 in response to the event was not reported. The outcome of the event, some of the vaccine spilled down the patient's arm, was considered resolved on 14 Jan 2021.; Reporter's Comments: This case concerns a male patient of unknown age who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Incorrect dose administered and Accidental exposure to product.

Other Meds:

Current Illness:

ID: 0984897
Sex: U
Age:
State: CA

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: soreness; vaccinated after the 6 hour mark; A spontaneous report was received from a hospital office manager concerning a patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced soreness and was vaccinated after the 6 hour mark. The patient's medical history was not provided. No relevant concomitant medications were reported. On 06 Jan 2021, it was reported that the facility was delivered 3 vials of the vaccine, with no documentation, from the Department of Public Health. Some vaccines were left out more than 6 hours punctured but were refrigerated. The vaccines were used to vaccinate staff and patients, approximately 20 people. Of the 20 people vaccinated at least 10 were vaccinated after the 6 hours mark. On 06 Jan 2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection and received vaccine that from a vial that had been punctured more than 6 hours previously. On an undisclosed date, the patient also experienced a soreness after receiving the vaccine. No details were provided. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the event, soreness, was not reported. The event, was vaccinated after the 6 hour mark, was considered resolved on 06 Jan 2021.; Reporter's Comments: This report refers to a case of product administration error for mRNA, where the vaccine was administered from a vial punctured more than 6 hours. The event of pain was associated with this case of out of specification product use.

Other Meds:

Current Illness:

ID: 0984898
Sex: F
Age:
State: CA

Vax Date:
Onset Date: 01/25/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Splash when vaccine was being administered and doesn't think she got 0.5 ml; A spontaneous report was received from a consumer concerning a 39-years-old, female patient who received Moderna's COVID-19 Vaccine (mRNA-1273), and reported splash when vaccine was being administered and she doesn't think she got 0.5mL. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On an unknown date, the patient received their first of two planned doses of mRNA-1273 on unknown date. On an unknown date, prior to the onset of the symptoms, the patient received their second of two planned doses of mRNA-1273 (Lot number 041L20) intramuscularly for prophylaxis of COVID-19 infection. On an unknown date, while receiving the second dose of vaccine it splash and the patient did not received full dose (0.5ml). The person who gave the vaccine said the hub was stuck on syringe. Treatment information was not provided. The patient received both scheduled doses of mRNA-1273 prior to the events; therefore, action taken with the drug in response to the events is not applicable. The outcome of the events, splash when vaccine was being administered and she doesn't think she got 0.5mL was considered resolved.; Reporter's Comments: This case concerns a 39-years-old, female patient who patient received their second of two planned doses of mRNA-1273 (Lot number 041L20) intramuscularly for prophylaxis of COVID-19 infection and reported a splash when vaccine was being administered and she doesn't think she got 0.5mL. There were no reported adverse events associated with the event of a splash when vaccine was being administered and she doesn't think she got 0.5mL.

Other Meds:

Current Illness:

ID: 0984899
Sex: F
Age: 35
State: OH

Vax Date: 01/07/2021
Onset Date: 01/14/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: None

Allergies: Amoxicillin

Symptoms: About a week after I received the 1st dose of the vaccination I noticed redness, swelling, and tenderness just below the the site of the injection. The symptoms lasted for about 24 hours before they resolved.

Other Meds: Levothyroxine Calcium + D3

Current Illness:

ID: 0984900
Sex: M
Age: 16
State: FL

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Vaccine given to a 16 year old; A spontaneous report was received from a parent concerning a 16-year-old, male, patient, who received Moderna's COVID-19 vaccine (mRNA-1273). The patient's medical history was not provided. No relevant concomitant medications were reported. On 22 Jan 2021, the patient received their first of two planned doses of mRNA-1273 intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 22 Jan 2021, the patient received his first dose of the Moderna vaccine and he is only 16 years old. The patient was fine and has had no side effects. Consent given for Safety to follow up. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine was administered to a 16 year-old, was considered resolved on 22 Jan2021.; Reporter's Comments: This case concerns a 16-year-old, male, patient who received their first of two planned doses of mRNA-1273 intramuscularly in the left arm for prophylaxis of COVID-19 infection. There were no reported adverse events per reporter for this case of product administered to patient of inappropriate age

Other Meds:

Current Illness:

ID: 0984901
Sex: U
Age:
State: CO

Vax Date:
Onset Date:
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: had a 16 year old who accidentally got the moderna covid vaccine; A spontaneous was received from a health care provider (HCP) concerning a 16-year-old patient who received Moderna's COVID-19 vaccine (mRNA-1273)accidentally. The patient's medical history was not provided. Products known to have been used by the patient, were not provided. On an unknown date, the patient accidentally received mRNA-1273 (Lot number: unknown) for prophylaxis of COVID-19 infection. Treatment information was not provided. Consent has been given to contact the HCP. HCP was inquiring as to whether or not the second dose of mRNA-1273 should be given. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the event, a 16-year-old accidentally receiving the vaccine, was considered resolved.; Reporter's Comments: This case concerns a 16-year-old patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product administered to patient of inappropriate age.

Other Meds:

Current Illness:

ID: 0984902
Sex: F
Age: 46
State: GA

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Fever, body aches

Other Meds: Ventalin, benzonatate, xanex prn

Current Illness: none

ID: 0984903
Sex: F
Age: 63
State: RI

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: Shellfish, watermelon

Symptoms: 1/25/2021- severe pain at vaccination site, I could not move my arm, was unable to sleep. 1/26/2021- dizzy, achy, chills, fever 101.8 degrees to 102.6 degrees. 1/27/2021- slept most of the entire day, achy, dizzy. 1/28/2021 & 1/29/2021- fatigue.

Other Meds: Levothyroxine, Atorvastatin, Zoloft, Multi-vitamin, Zyrtec, Nexium

Current Illness: None

ID: 0984904
Sex: F
Age: 45
State: NY

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: PCR Covid Swab

Allergies: NKDA

Symptoms: Aches, Chills, Headache, Fever

Other Meds: Symbicort, MVI, Estrace 1mg, Lipitor 20mg

Current Illness: Congestion

ID: 0984905
Sex: F
Age: 49
State: PA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Out-of-sequence COVID-19 vaccination was given. Person involved was a community member (non-affiliated healthcare provider) who showed up to a hospital based clinic that was administering first doses to 1A non-affiliated healthcare providers on 1/27/21. Unknown to the clinic organizers this person had previously received one dose of the Pfizer vaccine 13 days earlier (1/14/21). On 1/27/21 a dose of Moderna vaccine was administered and then after administration it was revealed that the person had previously received Pfizer and was not due for re-vaccination on 1/27/21. Person was held for routine observation and no side effects resulted. Person was provided with contact information for a hospital hotline to report any side effects that may result in the meantime. As of 1/29 no effects have been reported.

Other Meds:

Current Illness:

ID: 0984906
Sex: M
Age: 50
State: NE

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: I have freckles or spots on my entire body. These spots became much darker and much more noticeable about 24 hours later. At 36 hours after the initial dose, the spots are not noticeable again.

Other Meds: Zyrtec and daily vitamins

Current Illness: none

ID: 0984907
Sex: F
Age: 34
State: NH

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: N/a

Allergies: Kiwi

Symptoms: Body aches, headache, fatigue, fever Soreness and mild headache started within a few hours of the vaccine. The next morning I woke with severe headache, diffuse body aches, and low grade fever (99.3). Mid afternoon body aches resolved but headache progressed to a migraine. I also developed a 101.4 fever. All symptoms resolved overnight.

Other Meds: Lexapro, metformin, multivitamin, vitamin D, fish oil, cranberry supplement, biotin, probiotic, Zyrtec

Current Illness: None

ID: 0984908
Sex: M
Age: 33
State: NY

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: after receiving vaccine felt dizzy, for 10-15 min Vital signs 115/80 pulse 79 o2 sat 99% repeat 10mins later Vs 115/76 pulse 84 O2 sat 99%. Fluid hydration and monitored under observation. 911 dispatched and EMS arrived to the scene @ 1730 , declined to go to hospital , signed written waiver against medical advice and left facility

Other Meds:

Current Illness:

ID: 0984909
Sex: M
Age: 65
State: GA

Vax Date: 01/20/2021
Onset Date: 01/24/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: Covid test taken on 1/27 was negative.

Allergies: n/a

Symptoms: Vaccine taken on 1/20. 1/24 began symptoms of exhaustion, fatigue, headache and brain fog. 1/24 began additional symptoms of decrease /altered taste in mouth. symptoms last 3-4 days.

Other Meds:

Current Illness: n/a

ID: 0984910
Sex: M
Age: 58
State: NC

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Pfizer vaccine in LH arm, arm was sore for 2 days, arm continues to feel tender and has pins and needles feeling, worse when elevated or moved

Other Meds: Imbruvica, doxycycline

Current Illness:

ID: 0984911
Sex: F
Age: 54
State: PR

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: Thyroid hormone

Allergies: some

Symptoms: Whole body hot, then general malaise, cephalgia and insomnia.

Other Meds: none

Current Illness: none

ID: 0984912
Sex: F
Age: 29
State: NY

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient developed hives/rash on chest and arms immediately after receiving vaccine, administered 50 mg Benadryl po, took vitals twice fifteen minutes apart and was then driven home by her husband. Vital signs remained stable throughout episode.

Other Meds:

Current Illness:

ID: 0984913
Sex: F
Age: 35
State: MI

Vax Date: 01/19/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: none

Allergies: Penicillin

Symptoms: The injection site is itchy and splotchy however this was not a symptom until after a week of getting the shot. My arm is the only area of this rash like symptom. NO fever after injection has occurred. My arm is warmer to the touch than the other arm. I have taken progression pictures if needed to be emailed and dated. I have taken benedryl after I noticed the rash and seemed to have no changes.

Other Meds: Tylenol OTC omeprazole OTC Claritin All were used as needed unsure if any were taken the same day prior

Current Illness: NONE

ID: 0984914
Sex: F
Age: 32
State: PA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: None.

Allergies:

Symptoms: Patient developed red pinpoint rash all over arms, feet, trunk within 15 minutes of vaccine which eventually spread from trunk up abdomen to chest and neck. Patient vitals remained stable and had no problem breathing but rash spread and injection site was itchy. Patient was given benadryl cream at injection site and as rash spread, was given 25 mg oral benadryl. After 30 min observation, no change in symptoms. Rash did stop spreading, remained constant over arms, hands, chest and abdomen, flank, and feet. Did not extend to legs.

Other Meds: Lexapro 10 mg daily

Current Illness: None

ID: 0984915
Sex: F
Age: 40
State:

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
Hospital: Y

Lab Data:

Allergies: Gadolinium, PCN, Ceftin, Sulfa

Symptoms: Numbness and tingling in lips and oropharynx progressing to face; flushing and redness on chest, itching of hands, eyes, neck; nausea and stomach cramping all onset approx 30-40 minutes after vaccine. Treated in the emergency department w/ famotidine 50mg, solumedrol 125 mg, 1L NS. Noted frequent multifocal PVCs and runs of ventricular bigeminy during Emergency Dept evaluation and ongoing intermittent facial tingling and itching. Admitted for overnight observation.

Other Meds: Synthroid, Famotidine, Adderal XR, Zytrec

Current Illness: N/A

ID: 0984916
Sex: F
Age: 60
State: FL

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: Doxycycline, bentyl

Symptoms: Chills, low grade fever

Other Meds: Metoprolol, metformin, citalopram, levothyroxine

Current Illness: None

ID: 0984917
Sex: F
Age: 35
State: DC

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: N/A

Allergies: pork

Symptoms: generalized pruritus, onset 5-10 minutes after the vaccine, no other symptoms, vitals stable

Other Meds: None

Current Illness: non

ID: 0984918
Sex: F
Age: 33
State: PA

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: none

Allergies: Cherries, Sulfa Drugs, Oxycodone

Symptoms: bump at injection site. turned red and warm. moist heat does not help go down.

Other Meds: Metformin/Birth Control

Current Illness: none

ID: 0984919
Sex: F
Age: 55
State: IN

Vax Date: 01/26/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Injection was at 4:30/pm on January 26. January 27, 2021 I woke at 4:15/am with a major headache which lasted for approximately 15 hours. January 29, 2021 woke with swollen and sore lymph node under right armpit.

Other Meds: Aspirin Vitamin D Prozac

Current Illness: None

ID: 0984920
Sex: F
Age: 54
State: AR

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: NONE

Allergies: NONE

Symptoms: FEVER, SORE THROAT, BODY ACHES, HEADACHE

Other Meds: AMLODIPINE

Current Illness: NONE

ID: 0984921
Sex: F
Age: 52
State: GA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: Coedine

Symptoms: Chills, muscle aches, mild headache, swollen lymph node (right side near clavical), right arm pain at site of injection

Other Meds: Gaba, Zinc Picolinate,

Current Illness: None

ID: 0984922
Sex: F
Age: 32
State: TX

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Report of body aches, cough, congestion and sore throat. No home remedies. Outcome: referred for testing.

Other Meds:

Current Illness:

ID: 0984923
Sex: M
Age: 54
State: NC

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Arm where I got shot was very sore. To be expected. Around 6:30 in the evening I started feeling tired, sick, and sore all over. Got chills, feeling very cold. Took temperature at 8:00 pm and had a fever of 99.2. Had severe headache too. Took 2 acetaminophen tablets and went to bed. Chills got very severe, couldn?t stop shaking for a long while. Also felt very week. Had trouble sleeping, body very sore. Got up around 2:00 am and checked temperature again. It was 100.6. Took 3 acetaminophen and went back to bed. Severe headache persisted. Checked temperature at 8:15 am and it was 99.7.

Other Meds: Escitalopram, acetaminophen

Current Illness: None

ID: 0984924
Sex: F
Age: 54
State: NY

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: n/a

Symptoms: 102 fever body aches exhaustion splitting headache 36 hours

Other Meds: Synthroid Xyzal Crestor

Current Illness: n/a

ID: 0984925
Sex: F
Age: 43
State: NJ

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: na

Allergies: cannot digest lactase products lack enzymes

Symptoms: Arm pain , arm feels heavy and very painful. Lots of stomach growling, and some stomach discomfort, gases and diarrhea,

Other Meds: melatonin, Montelukast, rovustatin, multi vitamin, magnesium, vitamin d3, zinc w vit c

Current Illness: allergies, recurring sinus infections, gerd

ID: 0984926
Sex: F
Age: 56
State: FL

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Light headedness, headache, chills, fever, shivering, rapid heartbeat started at 7pm the same evening. Chills, fever, shivering continued at bedtime, 9pm through the night until approximately 3am. Light headedness, headache and weakness were still apparent at 5am. Took Tylenol 500MG since 9pm every 4 hours. 0900am of Jan 29, 2021, still a slight headache and fever subsided.

Other Meds: Synthroid 50 mcg tablet q am

Current Illness:

ID: 0984927
Sex: F
Age: 71
State: FL

Vax Date: 01/14/2021
Onset Date: 01/20/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: None

Allergies: Declomycin as a child

Symptoms: On day 6 he woke up feeling very weak. Needed help getting out of bed. He has a degenerative muscle disease (Inclusion Body Myositis) so is already very weak, wheelchair bound. House is set up with all lift chairs or elevated (Bed, Toilet) so he can get out of them with very weak legs. By mid morning he was not able to use legs or arms at all to get up and had difficulty holding head up (usually no problem). By afternoon temperature went to 103.6. and he ached all over. After 2 - 3 hours with dose of 2 extra strength Tylenol temperature came down to 100.6 and then another hour later he became very sweaty all over body and temp returned to normal. Continued very weak for a few days. Gradually regained strength and back to normal strength for him over 6 days.

Other Meds: Carvedilol 25 mg 1/2 tab twice/day; Entresto 49-51 1/2 tab twice/day; Warfarin 5 mg/day 5 days/ week and 7 mg 2 days/week; Furosemide 40 mg/day; Spironolactone 25 mg every other day; Multivitamin

Current Illness: Heart failure; Inclusion Body Myositis; Post Stroke (2012 right side affected); Elevated PSA;

ID: 0984928
Sex: F
Age: 75
State: FL

Vax Date: 01/20/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: none

Allergies: latex

Symptoms: on the evening of January 28,2021, I experienced mild itching on right arm and when I looked it was a light blotchy pink. It is the same this morning. I reported it to my doctor.

Other Meds: pravastatin 20mg lisinopril 20mg Vit D 30,000IU Centrum Silver 1 capsule calcium and magnesium 2 tablets zinc 25mg i tablet bayers baby apirin low dose 81mg 1 tablet preservision areds 2 2 tablets

Current Illness: none

ID: 0984929
Sex: F
Age: 35
State: AR

Vax Date: 12/21/2020
Onset Date: 12/31/2020
Rec V Date: 01/29/2021
Hospital:

Lab Data: CBC at PCP office

Allergies: NKA

Symptoms: ? Day 10 after vaccine #1 upper lip swelling AKA angioedema ? Day 6 post vaccine #2 lower right lip and upper right lip swelling. Scratchy throat ? Day 10 post vaccine #2 wheezing like an asthma attack ? Day 12 post vaccine #2 Left, lower lip swelling, tingling in my tongue ? itchy for 2 weeks, 14 days post vaccine #2. Developed a sporadic, ever changing rash ? Day 16 post vaccine #2 a different, new rash

Other Meds: Blisovi (birth control), one dose of duexis, Lil Critters Immune C + zinc & vit d

Current Illness: None

ID: 0984930
Sex: F
Age: 69
State: FL

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Extreme fatigue for 2 days

Other Meds: Trazadone 50mg Simvastatin Cymbalta 30 mg

Current Illness: none

ID: 0984932
Sex: F
Age: 58
State: TN

Vax Date: 12/30/2020
Onset Date: 01/06/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: None needed, do not need to contact my PCP who I left name and number and do not have to contact work if you do not have to. I read an article in paper today and wanted to help with results so you know how often happens. I am so thankful to have got both doses.

Allergies: Codiene, Hydrocodone, Oxycodone, Wasp stings.

Symptoms: Covid Arm- one week after shot got big red spot on same arm as shot was administered. Did not itch, warm to touch, also hard knot. About a 3 x 3 spot. Lasted two days.

Other Meds: Levothyroxine, Vitamin c, Vitamin D, Fish oil, Prenatal vitamins, Tummeric, B12

Current Illness: None

ID: 0984933
Sex: F
Age: 53
State: FL

Vax Date: 01/18/2021
Onset Date: 01/20/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: MOTRIN

Symptoms: Throat felt very tight, cough and sore throat. difficulty swollening. took Tylenol sinus and steriods 4mg started 8pm on the 1/20/21

Other Meds: ADVAIR FLONASE LOSARTAN GABAPENTIN PROAIR

Current Illness: NA

ID: 0984934
Sex: F
Age: 36
State: TN

Vax Date: 12/26/2020
Onset Date: 01/01/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: 2 negative COVID Tests- rapid test on 1/2/2021 and PCR test on 1/4/2021; 1 negative flu test on 1/4/2021

Allergies: sulfa

Symptoms: 6 days later - 101-102 degree degree fever for 3 days (1/1/2021-1/4/2021) followed by 3 days of migraine headache (1/5/2021-1/8/2021)

Other Meds: none

Current Illness: none

ID: 0984935
Sex: M
Age: 29
State: OK

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: Restless, chills, body ache, neck pain- (possible fever- did not take temp)

Other Meds: N/A

Current Illness: N/A

ID: 0984936
Sex: M
Age: 63
State: NY

Vax Date: 01/15/2021
Onset Date: 01/26/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: none

Allergies: no

Symptoms: 9 days later, red rash, minor swelling, some soreness and itching at site in left deltoid

Other Meds: Herbal: Curcuma Longa, Lysimachia GP, "Free and Easy Wanderer" (Chinese herbs), Triphala

Current Illness: no

ID: 0984937
Sex: M
Age: 33
State: IN

Vax Date: 01/27/2021
Onset Date:
Rec V Date: 01/29/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Felt fever flu like symptoms aches chills

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm